required almost six years to gather sufficient funding, find an appropriate focus, and perform the analysis. The final report covered sub-Saharan Africa and not the entire African continent. It was nonetheless an ambitious attempt to define the gender-related burden of health problems for females across the life cycle. As with all recent IOM reports, it began with an accessible summary that, for example, presented the main results in the form of two large tables. Furthermore, the book had an attention-getting main title, In Her Lifetime, and an arresting cover. Against a striking gold background, an impressionistic picture of an African woman, done in shades of red, orange, and black, appeared. It made quite a contrast to the utilitarian covers, in an institutional shade of yellowish gray, that had graced IOM reports through all of the 1970s and much of the 1980s. The old reports had consisted of photo-offset typescripts with jagged right margins; the new reports contained sleek type faces and crisp graphics that gave these publications a professional appearance and made them much easier to read.27

The chief drawback of studies such as the one on female morbidity in Africa was the length of time required to complete them. As part of the effort to respond more quickly to current concerns, the IOM started a number of informal forums. One was the Forum on Drug Development and Regulation, "a meeting ground for the exchange of ideas and information," that began in July 1986. The idea behind this effort, an experiment that soon evolved into a regular activity of the Institute's Board on Health Sciences Policy, was to provide "regular meetings in a nonadversarial environment for representatives from government, industry, and academia to discuss pharmaceuticals." Recognizing the value of such an institution, federal agencies concerned with drug development such as the Food and Drug Administration, professional organizations such as the American Medical Association, and private trade associations such as the Pharmaceutical Manufacturers Association all contributed to the forum's upkeep. The Forum on Drug Development, as the entity ultimately became known, involved little of the internal clearances and other hindrances that often delayed IOM initiatives. A unique use of the IOM's convening power, it made the IOM privy to the latest developments in the field and led to workshops on related topics, such as a 1990 workshop on the development of drugs for pediatric populations.28

A more ambitious effort to respond quickly to current health concerns began in the Fred Robbins's era with a 1983 report that recommended establishing a consortium for assessing medical technology. This idea attracted interest in Congress and led to the



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